142nd APHA Annual Meeting and Exposition

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Comorbid Diabetes and Depression and Increased Risk for Cognitive Impairment in Mexican Americans

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Tony Dickensheets, MA; MAIS , School of Public Health, University of North Texas Health Science Center, Fort Worth, TX
Background: Recent work from our group suggests that depression is a significant risk factor for Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) among Mexican-Americans, while many other "established" risk factors among non-Hispanic whites (e.g. education, gender, hypertension, diabetes, APOE4 genotype) are not. Another important risk factor among this population is diabetes (DM). Depression and DM have been shown to be pathologically linked, however, little research has examined the affect that comorbidity of depression  and DM has on cognitive impairment in an ethically diverse sample.

Methods:This study used data from three sedparate cohorts: HABLE, TARCC, and Project FRONTIER. Logistic regression analyses were conducted to examine comorbid diagnosis of depression and diabetes on Alzheimer's disease or MCI diagnosis. Covariates entered into the model were age, education, and gender.

Results: Comorbid diagnosis of diabetes and depression was significantly related to a diagnosis of MCI in Mexican-Americans across all three cohorts. TARCC (odds ratio=8.6, 95% CI=1.5-2.7); HABLE (odds ratio=2.4, 95% CI=1.3-3.2) and FRONTIER (odds ratio=2.6, 95% CI=1.2-6.4). TARCC was the only cohort with a large enough sample of AD patients to run the analyses split by ethnicity. In TARCC, comorbidity was related to AD diagnosis in MA (odds ratio=10.4, 95% CI=1.2-2.7) and narrowly related in non-Hispanic whites (odds ratio=8.3,95% CI=.14-1.4).

Discussion: Comorbid diagnosis of depression and diabetes increases risk for a diagnosis of cognitive impairment. Mexican-Americans were found to be at greater risk than non-Hispanic whites for MCI. These findings were validated across multiple cohorts, and could have significant clinical implications.

Learning Areas:

Clinical medicine applied in public health
Provision of health care to the public

Learning Objectives:
Discuss the possible comorbidity affects of depression and DM on cognitive impairment on an ethically diverse population. Explain that a comorbid diagnosis of depression and diabetes increases risk for diagnosis of cognitive impairment, and Mexican Americans were found to be at greater risk than non-Hispanic whites for MCI.

Keyword(s): Dementia, Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Since 2012 I have been a graduate research assistant in the Department of Internal Medicine under the tutelage of Dr. Sid O'Bryant, who is a national leader in this field, and Dr. Leigh Johnson. With them as my mentors I have learned much about this topic. I have presented posters at conferences at local, regional and international levels. I have helped to prepare manuscripts as well as being trained in the protocol for subject interviews.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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